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The Wrong Man for the Job

Why is Elliot Pellman still associated with the NFL?

By Patrick Hruby | Sports on Earth | May 2013

Bill Barr couldn't believe it. It was early last year, and the New York University neuropsychologist had just received an email from National Institutes of Health neurologist Russ Lonser, thanking Barr and other experts for reviewing a series of brain injury research grant proposals for NFL Charities, the National Football League's philanthropic arm.

A few hours later, a second message appeared in Barr's inbox.

Russ: thank you and your reviewers from myself and the entire charities board. Well done!

Elliot

"It was from Elliot Pellman," Barr says. "I was just surprised, thinking, 'Oh my gosh, he still has himself in there somehow.'"

You're an NFL player. You care about your brain. Do you want your health and safety connected in any way to a man who once wrote that concussions in professional football "are not serious injuries" and that "many [concussed] players can be safely allowed to return to play on the day of injury?" A man who spent nearly a decade downplaying and dismissing the long-term cognitive damage associated with repeated blows to the head, despite ample evidence to the contrary? A man who headed a league-created concussion committee that has been blasted by Congress, discredited by independent researchers and accused of producing dubious, industry-sponsored pro-tobacco pseudo-science that now serves as the smoldering gun for more than 4,000 lawsuits filed by former players against the league, alleging negligence and fraud?

So relentless, in fact, that Pellman is still giving the league medical advice.

Oh, and he's still involved with the league's brain-related health and safety efforts, too.

Three years ago, Philadelphia Eagles linebacker Stewart Bradley and quarterback Kevin Kolb both were concussed during the same game and allowed to continue playing before being pulled off the field, a dangerous practice now prohibited by NFL guidelines. During a subsequent league inquiry, Eagles trainers spoke to Pellman. In 2011 Cleveland Browns quarterback Colt McCoy was concussed on a vicious helmet-to-helmet hit from Pittsburgh Steelers linebacker James Harrison. After Browns trainers failed to administer a standard sideline diagnostic test, McCoy reentered the game. To determine how that happened, Browns team president Mike Holmgren later met with medical representatives from the players' union and the league. Including Pellman. Earlier that season, Eagles quarterback Michael Vick suffered a concussion and had to be examined by a neurologist before being cleared to play. Who reportedly helped choose the neurologist? Pellman.

On the same day last January that researchers reported that the brain of former NFL linebacker and suicide victim Junior Seau tested positive for chronic traumatic encephalopathy (CTE) -- a neurodegenerative disease associated with repetitive head trauma -- former NFL quarterback Bernie Kosar held an informal press conference in a Cleveland luxury hotel touting the work of Florida-based anesthesiologist Marvin "Rick" Sponaugle, whose controversial treatment of intravenous fluids and nutritional supplements Kosar credits with helping relieve his brain trauma-related ailments. Despite a lack of scientific evidence supporting Kosar's claims, NFL spokesman Greg Aiello confirmed that the retired quarterback had spoken about his treatment with Goodell; moreover, the league reportedly put Sponaugle in touch with -- you guessed it -- Pellman.

Pellman's precise role with the NFL is opaque. During a player health and safety presentation at the league's 2012 spring meetings, NFL executive Jeff Pash referred to him as "our medical director." On the website for his private practice, Pellman calls himself the league's "medical advisor," with duties that include "advising the league on medical and health matters" and "administrating NFL health committees." Contacted by Sports on Earth, Aiello confirmed that Pellman is a medical advisor to the league office, but does not establish policy or assist in the administration of the Head, Neck and Spine Committee, the successor to the now-defunct Mild Traumatic Brain Injury Committee once headed by Pellman.

Still: You're the head of the Federal Emergency Management Agency. Do you retain Mike Brown for advice and administration? Or send him to gather information from disaster relief sites?

"The NFL can say all they want about all the things they are doing [for player health and safety]," says retired NFL lineman Kyle Turley, one of the plaintiffs in the concussion lawsuits. "But you have to question why they have people like Elliot Pellman still involved with the league to this day. A guy like him is going to give us answers on this problem?"

* * *

Curiously enough, Pellman is not mentioned on the NFL's football safety website, nor in the pages of its first-ever Health and Safety Report, which contains the bold-faced names of dozens of doctors and scientists serving on various committees. Why the omission? Perhaps because people like Barr have called Pellman's continuing involvement with the league the equivalent of having "the fox guard the henhouse." And perhaps because the NFL would rather not talk about its ignominious recent brain trauma past, particularly while being sued over it.

(Speaking of which: The league's new-ish marketing magic wand wave safety slogan is "forever forward, forever football." As a wise man once put it: If you don't like what is being said, then change the conversation.)

When former NFL commissioner Paul Tagliabue formed the league's original concussion committee in 1994, he tabbed Pellman to run it. The Jets team doctor was a rheumatologist, specializing in joint and muscle injuries. He was not a neurologist. He later claimed in biographical material that he had a medical degree from the State University of New York at Stony Brook; according to The New York Times, he actually attended medical school in Guadalajara, Mexico. In a mid-1990s interview with Sports Illustrated, Pellman discussed players getting "dinged" and sounded: (a) not particularly scientific; (b) an awful lot like Dr. Nick Riviera:

"Veterans clear more quickly than rookies ... they can unscramble their brains a little faster, maybe because they're not afraid after being dinged. A rookie won't know what's happened to him and will be a little panicky. The veterans almost expect the dings. You have to watch them, though, because vets will try to fool you. They memorize the answers. They'll run off the field staring at the scoreboard."

According to a 2006 ESPN the Magazine article written by Peter Keating, several leading brain scientists were troubled by Pellman's lack of expertise. Neuropsychologists jokingly called him "Mr. Pellman." Another doctor told Keating that, "I would hear [Pellman] say things in speeches like, 'I don't know much about concussions, I learn from my players,' and, 'We as a field don't know much about concussions,' and it used to bother me. We knew what to do about concussions, but he was acting like it was new ground."

Medical research and policy conclusions coming out of the NFL's committee also proved equally disconcerting. Following nine years of academic silence, Pellman and his colleagues published a series of papers in the mid-2000s. They concluded that concussed professional football players, even those knocked unconscious, could be "safely returned to play" on the same day of their injury. That returning to play after a concussion did not involve "significant risk of a second injury either in the same game or during the season." That players with previous concussions had no risk of repeated concussions. That there was "no evidence" that multiple concussions produced "worsening injury or chronic cumulative effects." In a 2006 article, Pellman and co-author David Viano summed up 12 years of the committee's work by writing that concussions in professional football are not serious injuries.

Beginning in 1999, a series of University of North Carolina studies found that: (a) concussed football players were three times more likely to suffer a second concussion in the same season; (b) former NFL players who had been concussed during their careers were more likely to have neurological problems than those who had not; (c ) former NFL players faced a 37 percent higher risk of Alzheimer's disease than other males of the same age; (d) a history of repeated concussions and "probably subconcussive contacts to the head may be risk factors for the expression of late-life memory impairment, mild cognitive impairment and earlier expression of Alzheimer's."

Pellman's committee remained unconvinced. Nor did it acknowledge that some NFL general managers seemed to understand that concussions were serious injuries, and that multiple concussions were worse than one. How else to explain Pellman's team, the Jets, restructuring receiver Wayne Chrebet's contract in 2004 to include a "concussion clause" that would slash his salary from $1.5 million to $500,000 if he was placed on injured reserve -- a clause inserted after Chrebet, who previously had suffered at least five concussions, missed the last eight games of the 2003 season with post-concussion syndrome? How else to explain the Carolina Panthers signing linebacker Dan Morgan to a 2007 contract that paid out a $2 million roster bonus on a per-game basis, an unusual arrangement drawn up after Morgan suffered his fifth concussion? Even the league's own retirement board appeared less in denial than the concussion committee: According to a report by ESPN's "Outside the Lines" and PBS' "Frontline," it awarded disability payments during the late 1990s and 2000s to at least three former players after determining that football caused their crippling brain injuries.

Outside scientists criticized the committee's methodology as insular and slipshod, and its findings as both dubious and dangerous. In his ESPN the Magazine article, Keating describes a Pellman-headed committee study comparing the neurocognitive test scores of healthy players, concussed players and players who had suffered multiple concussions:

… a lot was riding on the analysis. The committee had never imposed recommendations on team medical staffs. But this was the first study ever to analyze the brain function of NFL athletes. If it showed that concussions were significantly impairing players, the league might be forced to institute new rules for evaluating and treating head injuries …

According to the article, Pellman and study co-author Mark Lovell failed to collect complete test score data from at least four individual team neuropsychologists, including Barr, and that as a result did not include at least 850 baseline test results in their research -- more than the 655 that ultimately were included in their study. "At best," Keating writes, "their numbers were incomplete. At worst, they were biased." (Lovell later sent a letter to the magazine staying "at no point was there ever an attempt to exclude teams from participating ... to suggest that there was an effort to suppress the collection of data for the study ... is completely baseless.") Published in 2004, the committee's paper concluded -- big surprise -- that NFL players did not show a decline in brain function after suffering concussions. An anonymous scientist who reviewed Pellman's work was apoplectic. "They're basically trying to prepare a defense for when one of these players sues," the scientist told Keating. "They are trying to say that what's done in the NFL is OK because in their studies, it doesn't look like bad things are happening from concussions. But the studies are flawed beyond belief."

"If you look at the papers they published in [the journal] Neurosurgery, they note no conflicts of interest," Barr says. "I thought that was the most hilarious thing."

Pellman defended his work, in part by attacking any scientist that contradicted it. When Omalu published his study of Webster's brain in 2005, Pellman and two of his committee colleagues wrote a letter to Neurosurgery demanding a full retraction -- almost unheard of in the academic world. (Three years later, the NFL finally asked independent neuropathologist Peter Davies to examine Omalu's findings; according to GQ magazine, Davies concluded that Omalu "was absolutely right … I was wrong to be skeptical." The league reportedly declined to make Davies' report public.) According to ESPN the Magazine , North Carolina researcher Kevin Guskiewicz was scheduled to appear on HBO in 2003 to discuss his research showing link between multiple concussions and depression in former NFL players. Before his appearance, he received a phone call from Pellman. "I had never spoken with him before, and he attacked me from the get-go," Guskiewicz told the magainze. "He questioned whether it was in my best interest to do the show. He was a bull in a china shop."

Barr can relate. In the early 2000s he worked with Pellman as a consulting neuropsychologist for the Jets, conducting preseason baseline tests on players and evaluating them again if they suffered concussions. "The boundaries were clearly set between us," Barr says. "I would provide objective cognition information -- cognitive dysfunction or not, detected through the testing -- and Elliot was in charge of all the return-to-play decisions. I felt he listened to my opinion and respected what I had to say. At that time, I had no problem with him."

Things changed in 2004. Also a research scientist, Barr had collaborated with Guskiewicz on a study of concussions in almost 3,000 college athletes. The study found that the best time to conduct neuropsychological tests of concussed players was after their symptoms had completely cleared, between five to 10 days after the injury -- longer than the one or two days that NFL teams preferred.

Barr presented his findings at a brain injury conference in New York City. About a week later, he says, he received a call from Pellman.

"He was angry," Barr says. "The study had received a lot of press. Elliot already had made a comment to me that he didn't really believe the findings. I had told him it was impeccable research design, very carefully done. Now somebody was telling him that I was saying bad things about the NFL. He told me if I was ever to say anything about sports concussions at all, I would have to clear it with him."

Barr was taken aback. I'm an NYU faculty member, he thought. I have more of a research background than you. You can't tell me what I can say about concussions.

"That's not going to happen," Barr recalls saying.

Pellman, Barr says, immediately fired him.

* * *

The committee's danger-denying, dissent-dismissing approach didn't just produce academic fights. It helped inform the NFL's laissez-faire concussion policy, putting players at additional brain trauma risk. In 1952 -- 1952! -- the New England Journal of Medicine recommended that football players leave the sport after suffering three concussions; 40 years later, Jets receiver Al Toon retired after suffering his ninth diagnosed concussion. (According to a 2011 New York Times report, Toon still suffers health effects, though he declined to discuss them publicly.) In 1997, the American Academy of Neurology recommended that concussed athletes knocked unconscious be withheld from play until asymptomatic for at least one week. The NFL rejected the recommendation. Seven years later, an international panel of sports concussion experts recommended that concussed athletes should not return to play the same day, even if they never lost consciousness. The NFL again rejected the recommendation, with Pellman subsequently writing in a paper that linking "concussion symptoms to arbitrary, rigid management decisions" was not "consistent with scientific data" and that team physicians should instead "treat their players on a case-to-case basis."

Among those team physicians? Pellman himself, who managed concussion care and return-to-play decisions for the Jets. In 1995 quarterback Boomer Esiason was concussed and missed four games. He later wrote a letter to The New York Times praising Pellman's handling of his injury. Chrebet's experience was different. During a 2003 game, he was knocked out. Drawing on a New York Daily News report, Keating described what happened next:

… "there's going to be some controversy about you going back to play." Pellman looks Chrebet in the eye in the fourth quarter of a tight game, Jets vs. Giants … a knee to the back of the head knocked Chrebet stone-cold unconscious a quarter earlier, and now the Jets' team doctor is putting the wideout through a series of mental tests. Pellman knows Chrebet has suffered a concussion, but the player is performing adequately on standard memory exercises."This is very important for you," the portly physician tells the local hero. "This is very important for your career." Then he asks, "Are you OK?"When Chrebet replies, "I'm fine," Pellman sends him back in …

Like Toon, Chrebet reportedly still suffers from post-concussive ailments. As does Turley. The former offensive lineman was diagnosed with two concussions during his NFL career. He believes he suffered dozens more. After getting knocked out while playing for St. Louis in 2003, he spent the night in a hospital. He played again the next week.

Today, Turley suffers from vertigo. His eyes can be sensitive to light. He sometimes battles troubling impulses. Suicidal thoughts. He takes psychiatric medication. He has a wife, a 2-year-old daughter and a 4-year-old son. He's afraid that football has damaged his brain.

"Why couldn't I have sat out a couple of games after getting knocked out?" Turley says. "Players all accept that the game is dangerous. We all accept that there's a high risk factor. But we did not accept or understand at all anything to do with concussions.

The NFL has a standard statement on the concussion lawsuits: Any allegation that the NFL intentionally sought to mislead players or otherwise conceal information from players concerning the risks, treatment or management of concussions is entirely without merit.

Still: You're the publisher of The New York Times. Do you hire Jayson Blair as a fact-checker?

"We did not know before the NFL admitted to this problem," Turley says. "Had that not occurred, only guys like myself who have had difficulties with this and have researched it would have the knowledge. Because guys like Pellman have done everything they can to hide it."

* * *

Eight years ago, Pellman testified before Congress. Jose Canseco was on hand. Mark McGwire, too. The subject was steroids. At the time, Pellman still was leading the NFL's concussion committee, and also was working as Major League Baseball's medical adviser.

(According to MLB spokesman Pat Courtney, Pellman currently has a "continuing relationship with the Commisioner's Office but now is focused on" the league's New York office workers. Sports on Earth is co-owned by USA TODAY Sports and MLB Advanced Media.)

In 2002, Pellman had said that "[baseball] players and the team owners have sold their souls to the devil with steroids, and I know, because I've been treating professional athletes since 1986." Things change. Addressing lawmakers, Pellman still touted his experience, testifying that "unlike some other medical professionals you will hear from today, I have had extensive experience in the area of professional sports." He then defended baseball's steroid policies, calling them as rigorous as those in any other professional league.

Congressional members were unimpressed. Scornfully so. They forced Pellman to admit that he was not aware of a loophole that would allow a player to leave the room for an hour during a drug test, nor of a loophole that would allow a $10,000 fine instead of a 10-day suspension for a first offense. One lawmaker called Pellman "pathetically unpersuasive" and likened him to a tobacco industry executive; another found Pellman "unable to answer even the most basic questions" about baseball's steroid policy.

Does any of this sound familiar?

After Pellman stepped down as the head of the NFL's concussion committee in 2007, Guskiewicz called him "the wrong person to chair the committee from a scientific perspective" and "the right person from the league's perspective." When the NFL shut down the committee three years later and asked neurosurgeons Hunt Batjer and Richard Ellenbogen to create a new Head, Neck and Spine group, the two doctors said they would not use any of the old committee's data or ongoing studies on helmets and retired players' cognitive decline -- all of which had been overseen by Pellman and blasted by Congress as "infected" -- because they didn't want their "professional reputations damaged." They also asked Pellman not to speak at a league-sponsored brain injury conference, with Batjer telling The New York Times that "it's not about Elliot. It's about a complete severance from all prior relationships from that committee."

About those severed prior relationships: Pellman committee member Rick Burkholder, a former Eagles athletic trainer, is now the head trainer of the Kansas City Chiefs. Members Andrew Tucker and Doug Robertson remain team physicians for the Baltimore Ravens and Indianapolis Colts, respectively. Members Mark Lovell and Joseph Maroon -- a neuropsychologist and a neurosurgeon -- both reportedly remained NFL advisers as of last year. New York Giants athletic trainer Ronnie Barnes, Colts neurosurgeon Henry Feuer and former Chiefs physician Joe Waeckerle all served under Pellman and remain closely involved with the league's brain health and safety policy, because all three are members of the reconstituted committee.

Like Pellman, they've all managed to keep themselves in there, somehow.

"I hadn't realized that was going on," says Eleanor Perfetto, the widow of former NFL player Ralph Wenzel and a plaintiff in the concussion lawsuits. "I guess I find it surprising since the NFL was claiming to make changes and improve what was going on.

"Say that you're one of these [former players] who is [brain damaged] and struggling. And your family is struggling, because there's a lot of stress from dealing with your illness. How do you feel hearing that Pellman is still involved? This man who was part of the smokescreen of denial?"

Perfetto knows struggle. She watched her husband slowly degenerate from a fit, energetic high school football coach in his early 50s to a dementia ward resident who couldn't walk, write or bathe himself. Who could only eat his favorite apple cinnamon doughnuts if they were first mashed up. When Ralph died last year at age 69, he had dropped from 225 pounds to 140 pounds; a scientist who examined his brain said it had shrunk to the approximate size of a 1-year-old's. He was posthumously diagnosed with CTE and Alzheimer's.

"If you say you're going to do away with you old committees, start with a clean slate, get the right people involved to do the right thing, why do we still have these lingering remains of that old negative effort?" she says. "Why would they not completely divest themselves of the committee they had put together that really had done such poor, shoddy work? It's more evidence that the NFL is not as serious about handling this as properly as they say they are."

An optimist might believe that Pellman remains in the league's orbit because he has something positive to contribute. A cynic might suspect that he's kept around because he knows where the bodies are buried. A realist -- and by realist, I mean a couple of smart lawyers I know -- might observe that the NFL has painted itself into a corner, regardless of its intentions, and that the league can neither cut ties with nor fully repudiate Pellman and the committee. At least not now. Not when the league's legal defense largely consists of insisting that nobody ever did anything wrong.

On the other hand: You are an Italian cruise ship company. Do you give Captain Francesco Schettino within 50 nautical miles of the Costa Concordia?

Ten days after Pellman allowed Chrebet back on the field against the Giants in 2003, the receiver was placed on injured reserve. He was sluggish. Exhausted. His head hurt. His season was over. Post-concussion syndrome. Speaking to reporters, Pellman was unapologetic. He said that Chrebet's diagnosis was unrelated to his return to play. That the decision to re-enter the game was based on scientific evaluation. That he was ending Chrebet's season so he -- Pellman, that is -- could sleep well at night.

"Nobody gets second-guessed," Pellman said.

Last week, Goodell delivered a speech at a sports medicine conference in Boston. "We consider the health and safety of our athletes our first priority," he said. "And our second and our third priority." During Super Bowl week, the NFL Players Association released a survey showing that around 90 percent of its members don't trust team medical staffs and are not satisfied with the way their team manages injuries. Can you blame them? Elliot Pellman still works with the NFL. Nobody gets second-guessed.